The role of GPs in treating psychological distress: a study of midlife Australian women

Background. Patient satisfaction with general practice care is important for treatment adherence, yet little is known about women's satisfaction with general practice care in relation to emotional problems. Objectives. The purpose of the present study was to explore women's perceptions of the help provided by GPs for psychological distress. Methods. Qualitative and quantitative data were gathered using semi-structured telephone interviews in NSW Australia. The respondents were 322 women aged 45-50 who participated in the baseline survey of Women's Health Australia (WHA). Results. Of the 309 women who had had a period of distress in the previous 12 months, 159 [52%, confidence interval (CI) 46.4-57.6] had talked to a GP about their difficulties. Listening was the main help given by GPs (68%, CI 60.7-75.3), followed by a prescription for medication (55%, CI 47.2-62.8) and referral to specialist care (13%, CI 7.8-18.2). Few women reported specific behavioural interventions, such as counselling (4%, CI 0.9-7.1) or relaxation (1%, CI 0 to 2.6). There was a relatively high degree of satisfaction with referral, counselling and relaxation advice amongst those who received these treatments. In contrast, a fifth of women who received a prescription or were listened to found these treatments unhelpful (20%, CI 11.6-28.4; and 21%, CI 14.2-29.8, respectively). Thematic analysis highlighted three main concerns for women, namely structural limitations of the GP-patient consultation, GPs' limited interpersonal skills and GPs' limited interest, knowledge and skills in mental health. Conclusion. While most women find their general practic care helpful, many reported shortcomings in terms of both GP skills and structural limitations of the consultation. These findings are useful in informing the development of training programmes for GPs.